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Sunday Q-and-A: Dr. James Andrews cuts to the chase — there are ways to prevent kids in the operating room

Washington quarterback Robert Griffin III needed three different repairs on his right knee this week by Dr. James Andrews after injuring it in the Redskins’ playoff loss to Seattle. (Photo by Getty Images)

This time, Dr. James Andrews had an up-close-and-personal encounter with Robert Griffin III’s right knee.

The renowned athletic surgeon spent hours at his Florida clinic on Wednesday to repair the lateral collateral ligament, reconstruct the partially torn anterior cruciate ligament and fix up the medial meniscus for the Washington Redskins rookie quarterback.

Dr. James Andrews watches from the sidelines during the 2013 BCS Championship game between Alabama and Notre Dame on Monday, Jan. 7. He operated on Robert Griffin III’s knee two days later. (John David Mercer-USA TODAY Sports)

He also needed just a couple of seconds to insist his own reputation was hardly damaged after a rehash of conflicting reports that he allowed the former Heisman Trophy winner to return to a game last December without fully examining his tweaked knee on the sidelines after it happened..

“Of course not,” Andrews said the other morning, asked if he was concerned how his actions were perceived. “People don’t understand what goes on down on the football field. The coach (Redskins head coach Mike Shanahan) didn’t know what we were really saying. I’ve put that all behind me now.”

It’s not as if Andrews, on the Alabama sidelines during their BCS title game victory over Notre Dame on Monday, needed any more excitement this week.

He said he wasn’t at liberty to explain how RGIII’s surgery went, only that he’s “well on his way to recovery” and, after eight months of projected rehab, he’ll likely start the 2013 season.

“He’s such a great kid, unbelievable,” the 71-year-old Andrews said of the 22-year-old.

Interestingly, USA Today tracked down Robert Griffin II for his opinion of the surgery. Quoting him in Friday’s editions, RGIII’s father declared the injury was “not as bad as everybody thinks. . . . When he sees his coaches and everyone else, it’s going to be like nothing ever happened.”

Along with that vote of confidence, Andrews might want to slip RGII a copy of his new book, “Any Given Monday: Sports Injuries and How to Prevent Them, For Athletes, Parents and Coaches – Based on My Life in Sports Medicine” (Scribner, $25, 270 pages, with Don Yaeger).

Not to imply that RGII falls into the category of parents who are often are the ones blinded most by their child’s athletic potential, and get caught up most by delusions of grandeur. But there’s a trap door there, and almost any dad or mom can look guilty at some point of pushing their children unnecessarily past their natural athletic resistance, unaware of the proper training methods, and the results can be expensive.

Which is where Andrews often comes in.

To his credit, he is trying to take the lead in preventive medicine, rather than reactive repairing. He’s had too many first encounters with young athletes on an operating table.

Andrews explained how this new reference book, the proceeds from which will go toward a sports injury campaign organization he helped launch in 2009 (www.stopsportsinjuries.org), can be put to its intended purpose:

QUESTION: How disheartening – if that’s the right word – is to see a 14-year-old pitcher nowadays come into your office expecting you to magically fix his elbow?
ANSWER: Well, let me tell you, you just look at him and say, “Why did this happen? What can we do to prevent this?” And the parents are the ones who say, “We’ve done everything we could to make sure our son had a chance to develop in a sport,” but most times, they’ve had no clue the injury risks involved. They claim, “We didn’t know he could get hurt doing that.” It’s all a matter of education.

The real problem, though, is it feels like the tail wagging the dog here. There are sports coaches who tell them that their kid can’t play with him unless they do it year-around in their travel leagues. The parents may understand their kids need time off, but they can’t do anything about with how it’s set up. Is money a factor in all this? Of course it is. Youth sports is a huge industry. It’s almost to the point to where dollar is more important than the health of the kid. That’s a pretty harsh statement. But I’ve seen it.

Q: So then how does an overscheduled parent make the time to read a book like this? Isn’t there a better chance that the kid will read it and tell them how it’s done? Or even a grandparent?
A: Grandparents really seem to have more sense about all this. I had six kids who all grew up playing sports, having injuries, and I really didn’t think a lot of it. Now I have six grandkids, and I’m more worried about what they do perhaps than I was with my own kids. As they mature, you see what happens.
I’m really trying to make sure grandparents read this also. Some of the parents are very conscientious, but there are others who are fanatics – and they’re the ones often coaching their kids. California and Florida are the real hotbeds of injuries, but now I’m seeing it in North Dakota, Connecticut . . . everywhere. You can imagine the socio-economic impact of these kids getting hurt in high school. And down the road, there’s the progression of injury, arthritis, and then they don’t participate in sports any more. We want them to be healthy and something needs to be done about it. The federal government needs to get involved. They’ve been big on nutrition and childhood obesity, but I don’t think they realize how the escalation of sports injuries has affected the health costs. If they’re not careful, the legal people will get involved in all this.

Q: Why don’t more other doctors speak up about this thing that you call an “epidemic”? Do they worry that they’ll be out of business if there aren’t enough injured athletes to treat?
A: It’s amazing how it took 10 years to get this (prevention) project flowing, to make sure everyone was on the same page. The time has been right over the last couple of years for all the doctors – sports medicine, primary care, trainers, physical therapists, the pediatric group even – to get behind this. Initially, you couldn’t get anyone because they were so interested in the advances in how to fix people. Now, the message that I bear is to get people to pay attention. I’m always talking to people about this issue, but we haven’t made a dent in it. But all the time and money put into the research of repairing sports injuries, you wouldn’t believe it.

Q: One of the things you address are the myths many have about injuries – the biggest, that you can become better and stronger after a surgery. Why does that illogical statement get stuck in their heads? Watching too many old episodes of “The Bionic Man” or something?
A: I think there’s big-time athletes who say they’re better after a Tommy John surgery, and the media exploits that a bit. In trying to take a positive attitude with athletes, in trying to motivate them, maybe it’s me, too, who will say, “You’re throwing better than you ever have.” But then look at all the work they do after the injury. Some haven’t done that much before. They float along with their natural ability. Then you add this rehab and performance training, they feel better because of it. But it’s not the case of what we did (in surgery). I tell them in no uncertain terms: We can’t rebuild a ligament in the human body as well as the Good Lord built it.

Q: We’ve read you’re also interested in doing more with stem cell research. How is that progressed?A: That’s the future. That’s not for enhancing a performance, either. That’s biological healing enhancement, so there’s not a year and a half to recover from an ACL injury. That’s a long time to miss a sport, particularly with young kids who get passed up, lose a scholarship out of high school. If we can enhance the healing potential, it would be great.
It’s been progressing at a snail’s pace but the FDA is doing the right thing to make sure we’re don’t have a bunch of charlatans out there advertising things that, “My stem cells are better than yours.” We’re more controlled here than other countries to some degree, and others are ahead of us with it like Japan and Germany. We’ve got to catch up, but in a research basis, and again, the problem is the cost of it in studies. In the meantime, it will be controlled to the very basic stuff that’s allowed in the U.S. We’re not talking about embryonic stem cells, but ones taken from one patient to another. All that’s perfectly legal. You can’t manipulate it or control it in a lab.

Q: Do most solutions to the injuries that kids have on the playing field really come down to using common sense? Especially when they’re blinded by these goals of athletic greatness and just doing what they’re told to “follow their dreams”?
A: The risk factors in youth baseball is competing year-around and specialization. Parents need to understand they can’t always hire pitching coaches two nights a week in addition to the workload they’re son is already doing. They need the proper mechanics, but all that adds up. We’ve already seen pitch count restrictions in Little League have a positive effect on injuries. They lead the way in safety and health of a kid of most organizations – and I’m not just saying that because I’m on their board.
But then kids goes to these showcase workouts, to see how hard they can throw off the mound, then they’ll blow their ligament out at the cost of a scholarship.
When I’ve had a kid in high school who hurt his elbow or shoulder, and I’ve talked to him about going to another sport so he could avoid a surgery, every one of them in my experience will say, “But my dream is to play baseball.” And the parents will often speak up for the kid before he has a chance to answer that question.
Even kids coming out of college now, they get hurt their senior year, they don’t have a chance of playing professional baseball, but it’s hard to convince them to take a conservative approach and going on to focus on something else. I went through that. I was a pole vaulter at LSU and went to medical school my senior year. I still dream about what I could have done instead (as an athlete). It’s hard on everyone, particularly if you go out with an injury and not go out on your own terms. You have to understand the psychology of all that and try to help these kids.

Q: It sounds like then there’s a need for a whole different kind of doctor to fix that problem.
A: I’m telling you, that’s why I’m so passionate to get this done. I’m in the twilight of my career, but I really want to see this attitude change. I’ll devote as much time to it as I can. Of course, you can’t prevent all injuries – they’ll always happen. But we can’t keep seeing this five- to seven-fold increase like we’ve seen since 2000.

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